Dear Steve; I came across an article you wrote when
I was Googling about an issue I am having with Walmart filling my Lorazepam prescription. My PCP has me call her office every month for a new script to be sent to Walmart for my 1mg
tablet that I take at night for anxiety. (I want to add here that I suffer from chronic pain due to serious issues with my cervical and lumbar spine, and was also diagnosed with Chiari Malformation at age 60) I had had no problems with my Lorazepam being filled for many years with Walmart until about 7 months ago. My script got sent in by my doctor as usual, and it was showing as delayed online when I checked. At that point I had already taken my last dose and called Walmart to ask why the delay. I was told by the pharmacist that they dropped the ball with me and I should have been providing them with a recent office visit note from my PCP. And that this is a DEA rule. Every six months a report is required from the doctor, and it isn’t the responsibility of the pharmacy to request that from the doctor to fill the script. The doctor should know this. So I called my PCP and apparently they sent the note because my script was filled. That note was sent in March 2025. When my doctor sent in the script for my May refill, again it comes up delayed. I called Walmart and was rudely told by the pharmacist that I have been on this medication for a long time, and a report or phone call from my doctor is required before they will fill it. So I contact my PCP again about this. At this point on May 20th, I have been two days without my medication. My PCP told me that the pharmacist is WRONG and the doctor sends a script in because the patient requires whatever the medication is. (I understand that Lorazepam is now considered a controlled substance. I also know that I do not EVER get a script from my doctor with refills on it for Lorazepam.) Are my doctor and myself wrong in thinking that my prescription should be filled without my personal medical reports be sent to them? That they should fill this script because it’s a new one every month? Your advice on this would be greatly appreciated. By the way, I also filed a complaint with Walmart through the corporate complaint line. I was told by the representative that the pharmacist is wrong. I will see today if the script is filled or not.
I do not know which state this pt lives but I have heard about any LAW that requires such procedures to get a C-4 refilled, so I ask www.perplexity.ai. It would appear that this particular Pharmacist is making up his own “rules” , and telling the pt that IT IS THE DEA LAW!
Is there a DEA rule that a pt must have an office visit every 6 months to get a controlled med filled, in particular Lorazepam?
There is no DEA rule that specifically requires a patient to have an in-person office visit every six months in order to receive a prescription for a controlled substance such as lorazepam (Ativan), which is a Schedule IV controlled substance37.
DEA Requirements for Controlled Substance Prescribing
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Initial In-Person Evaluation: Under the Ryan Haight Online Pharmacy Consumer Protection Act, a prescriber must conduct at least one in-person medical evaluation before prescribing any controlled substance, including lorazepam24. Exceptions exist for certain telemedicine scenarios, but these are specific and do not generally apply to routine outpatient care.
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Telemedicine Flexibilities: If a patient has already had an in-person visit with the provider, the DEA allows ongoing prescribing of controlled substances (including via telemedicine) without additional in-person visit requirements, unless otherwise specified by state law or clinical judgment14.
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Refill and Expiration Limits: For Schedule IV medications like lorazepam, prescriptions may not be filled or refilled more than six months after the date written, and may not be refilled more than five times7. This is a dispensing and refill limitation, not a mandate for a new office visit every six months.
State Law and Clinical Practice
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State Regulations: While the DEA does not mandate a six-month visit interval, individual states or insurance companies may have their own requirements for the frequency of patient evaluations for ongoing controlled substance prescriptions. These requirements can vary and may be stricter than federal rules.
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Clinical Standards: Many prescribers and clinics, as a matter of good clinical practice, require periodic follow-up visits (often every 3–6 months) to monitor for efficacy, side effects, and potential misuse, especially with benzodiazepines like lorazepam due to their risk profile3. However, this is a clinical or policy decision, not a DEA regulation.
Summary Table
| Requirement | DEA Federal Rule | Typical Clinical/State Practice |
|---|---|---|
| Initial in-person visit | Required | Required |
| Repeat visit every 6 months | Not required | May be required by state/clinic |
| Prescription expiration | 6 months | 6 months |
| Max refills (Schedule IV) | 5 | 5 |
Conclusion
The DEA does not require an office visit every six months to continue prescribing lorazepam or other Schedule IV controlled substances. The main federal requirements are an initial in-person evaluation and adherence to prescription expiration and refill limits. Additional visit frequency requirements, if any, are set by state law, insurance, or individual provider policy—not the DEA237.
Citations:
- https://www.dea.gov/press-releases/2025/01/16/dea-announces-three-new-telemedicine-rules-continue-open-access
- https://www.nixonpeabody.com/insights/alerts/2025/01/27/dea-announces-proposed-regulations-on-telemedicine-prescribing-of-controlled-substances
- https://www.singlecare.com/blog/is-lorazepam-a-controlled-substance/
- https://www.fenwick.com/insights/publications/understanding-the-deas-new-telemedicine-rules-faq-for-healthcare-providers-and-telehealth-companies
- https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-071)(EO-DEA226)_Practitioner’s_Manual_(final).pdf
- https://www.hklaw.com/en/insights/publications/2025/01/dea-extends-access-to-telehealth-treatment-with-new-rules
- https://www.drugs.com/medical-answers/rules-controlled-substance-prescription-refills-3572555/
- https://www.aha.org/news/headline/2025-01-15-hhs-dea-release-rules-related-telemedicine-prescribing-controlled-substances
- https://apps.deadiversion.usdoj.gov/guidance
- https://titangroupdea.com/dea-controlled-substance-regulations/
- https://www.mcdermottplus.com/insights/dea-extends-telemedicine-flexibilities-for-controlled-substance-prescribing-through-december-31-2025/
- https://telehealth.hhs.gov/providers/telehealth-policy/prescribing-controlled-substances-via-telehealth
- https://www.in.gov/dhs/files/DEA_Practicioner_Manual.pdf
- https://www.dea.gov/press-releases/2023/02/24/dea-announces-proposed-rules-permanent-telemedicine-flexibilities
- https://www.dea.gov/sites/default/files/2023-02/Controlled%20Substance%20Guidance.pdf
- https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-046R1)(EO-DEA154R1)_Pharmacist’s_Manual_DEA.pdf
Answer from Perplexity: pplx.ai/share
Filed under: General Problems
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